Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.57 / $12.57 / $18.68	Facility	26	$12.57	$12.57	$18.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.39 / $25.39 / $102.65	Facility	TC	$25.39	$25.39	$102.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.67 / $38.03 / $55.93	Professional		$33.67	$38.03	$55.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $13.91 / $19.92	Professional	26	$12.19	$13.91	$19.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.58 / $25.39 / $36.01	Professional	TC	$21.58	$25.39	$36.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $11.07 / $11.07	Professional	26	$11.07	$11.07	$11.07
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $92.57 / $123.42 / $123.42	Facility	TC	$92.57	$123.42	$123.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.27 / $56.00 / $101.00	Professional		$41.27	$56.00	$101.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.84 / $26.50 / $42.50	Professional	26	$13.84	$26.50	$42.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.43 / $31.90 / $67.00	Professional	TC	$27.43	$31.90	$67.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.17 / $51.78 / $98.88	Professional		$41.17	$51.78	$98.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $20.27 / $36.83	Professional	26	$16.07	$20.27	$36.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.47 / $32.64 / $60.19	Professional	TC	$24.47	$32.64	$60.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $26.88 / $47.67	Facility	26	$17.32	$26.88	$47.67
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $35.27 / $35.27 / $66.14	Facility	TC	$35.27	$35.27	$66.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $165.67 / $165.67 / $165.67	Professional		$165.67	$165.67	$165.67
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $110.95 / $110.95 / $110.95	Professional	TC	$110.95	$110.95	$110.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $34.77 / $51.41	Professional		$25.48	$34.77	$51.41
United Facility/Professional Professional Modifier Low / Median / High Price $37.71 / $52.60 / $86.39	Professional		$37.71	$52.60	$86.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.94 / $19.39 / $31.84	Professional	26	$14.94	$19.39	$31.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.43 / $32.74 / $57.08	Professional	TC	$22.43	$32.74	$57.08